Carotid intima media thickness is associated with plasma lipoprotein-associated phospholipase A2 mass in nondiabetic subjects but not in patients with type 2 diabetes
Version of Record online: 31 JAN 2011
© 2011 The Authors. European Journal of Clinical Investigation © 2011 Stichting European Society for Clinical Investigation Journal Foundation
European Journal of Clinical Investigation
Volume 41, Issue 8, pages 820–827, August 2011
How to Cite
Constantinides, A., van Pelt, L. J., van Leeuwen, J. J. J., de Vries, R., Tio, R. A., van der Horst, I. C. C., Sluiter, W. J. and Dullaart, R. P. F. (2011), Carotid intima media thickness is associated with plasma lipoprotein-associated phospholipase A2 mass in nondiabetic subjects but not in patients with type 2 diabetes. European Journal of Clinical Investigation, 41: 820–827. doi: 10.1111/j.1365-2362.2011.02471.x
- Issue online: 6 JUL 2011
- Version of Record online: 31 JAN 2011
- Received 14 October 2010; accepted 24 December 2010
- Intima media thickness;
- lipoprotein-associated phospholipase A2;
- metabolic syndrome;
- type 2 diabetes mellitus
Eur J Clin Invest 2011; 41 (8): 820–827
Background A recent meta-analysis showed that both plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) mass and activity independently predict cardiovascular events. Notably, Lp-PLA2 activity but not mass was found to be a determinant of cardiovascular outcome in type 2 diabetes mellitus. We questioned whether relationships of carotid intima media thickness (IMT), a measure of subclinical atherosclerosis, with Lp-PLA2 mass differ between diabetic and nondiabetic subjects.
Materials and methods Relationships of IMT with plasma Lp-PLA2 mass (turbidimetric immunoassay) were compared in 74 patients with type 2 diabetes and in 64 nondiabetic subjects.
Results IMT was increased (P = 0·016), but plasma Lp-PLA2 mass was decreased in patients with diabetes compared to nondiabetic subjects (277 ± 66 vs. 327 ± 62 μg L−1, P < 0·001). In nondiabetic subjects, IMT was correlated positively with Lp-PLA2 (r = 0·325, P < 0·009); multiple linear regression analysis confirmed an independent association of IMT with Lp-PLA2 (ß = 0·192, P = 0·048). In contrast, IMT was unrelated to Lp-PLA2 in patients with diabetes (r = 0·021, P = 0·86), and the relationship of IMT with Lp-PLA2 was different in diabetic and control subjects (P < 0·001). The relationship of Lp-PLA2 with the total cholesterol/high-density lipoprotein (HDL) cholesterol ratio also differed between diabetic and nondiabetic subjects (P < 0·001).
Conclusions Plasma Lp-PLA2 may relate to early stages of atherosclerosis development. In diabetes mellitus, in contrast, the association of IMT with plasma Lp-PLA2 mass is abolished, which could be partly ascribed to redistribution of Lp-PLA2 mass from apolipoprotein B-containing lipoproteins towards HDL. These findings raise questions about the usefulness of plasma Lp-PLA2 mass measurement as a marker of subclinical atherosclerosis in type 2 diabetes mellitus.